Benjamin Dastrup (NPI# 1073797809, PAC ID# 8628123783) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPHTHALMOLOGY.
| Nation Provider ID (NPI) | 1073797809 |
| PAC ID by PECOS | 8628123783 |
| Professional Enrollment ID | I20100705000013 |
| Full Name | Benjamin Dastrup |
| Organization Legal Name | COUNTRY HILLS EYE CENTER |
| Address |
875 Country Hills Dr Ogden UT 84403-2200 |
| Phone Number | 8013991149 |
| Gender | M |
| Medical School | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
| Graduation Year | 2005 |
| Primary Specialty | OPHTHALMOLOGY |
| Group Practice PAC ID | 4688629769 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460004 | MCKAY DEE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 875 Country Hills Dr, Ogden, UT 84403-2200 | 8013991149 | COUNTRY HILLS EYE CENTER |
| Organization Legal Name | COUNTRY HILLS EYE CENTER |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley W Richards | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| Jackson Finlinson Lever | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| David E Brodstein | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| Street Address |
875 COUNTRY HILLS DR |
| City | OGDEN |
| State | UT |
| Zip | 84403-2200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley W Richards | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| Jackson Finlinson Lever | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| David E Brodstein | Ophthalmology | Country Hills Eye Center | 875 Country Hills Dr, Ogden, UT 84403-2200 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott M Howes | Clinical Social Worker | 2748 Adams Ave, Ogden, UT 84403-0106 | |
| Greg M Pickett | Optometry | 1196 30th St, Ogden, UT 84403-0353 | |
| Mona D Oversteg | Occupational Therapy | 1771 Doxey St, Ogden, UT 84403-0523 | |
| Susan M Agres | Podiatry | 1322 32nd St, Ogden, UT 84403-0902 | |
| Lincoln J Dygert | Optometry | Ogden Vision Center | 3475 Harrison Blvd, Ogden, UT 84403-1230 |
| Scott D Peterson | Optometry | 3988 Washington Blvd, Ogden, UT 84403-1826 | |
| Krystal M Tipping | Certified Registered Nurse Anesthetist (crna) | Mt Ogden Anesthesia Group LLC | 4364 Washington Blvd, Ogden, UT 84403-1866 |
| Julie I Dee | Anesthesiology | 4364 S Washington Blvd, Ogden, UT 84403-1866 | |
| Scott O Sykes | Ophthalmology | Mt Ogden Eye Center LLC | 4360 Washington Blvd, Utah Eye Centers, Ogden, UT 84403-1866 |
| David A Johnson | Anesthesiology | Mt Ogden Anesthesia Group LLC | 4364 Washington Blvd, Ogden, UT 84403-1866 |
| Find all physicians in zip 84403 | |||
| City | OGDEN |
| Zip Code | 84403 |
| Specialty | OPHTHALMOLOGY |
| City + Specialty | OGDEN + OPHTHALMOLOGY |
Please comment or provide details below to improve the information on Benjamin Dastrup.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.